妊娠期重金属暴露及其与不良出生结局的关系:一项横断面研究

IF 3.8 2区 医学 Q2 ENVIRONMENTAL SCIENCES
Geohealth Pub Date : 2025-10-03 DOI:10.1029/2025GH001471
Tianao Sun, Zhanyue Zheng, Minli Yang, Minglian Pan, Qitao Tan, Yongjie Ma, Yingjie Zhou, Muxue He, Yan Sun
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引用次数: 0

摘要

产前重金属暴露一直是国际上研究的焦点。然而,目前的研究倾向于孤立地检查单个金属,并依赖于传统的线性回归模型,这可能无法充分反映混合金属暴露的复杂、非线性和相互作用影响。本研究的目的是利用先进的机器学习方法,调查怀孕期间母亲混合尿HM暴露水平与不良出生结局(如早产(PTB)、低出生体重(LBW)和小于胎龄(SGA)婴儿)之间的关系。本研究于2022 - 2023年在桂林市某三级医院进行。共有489名孕妇被纳入研究。收集孕早期尿液样本,使用电感耦合等离子体质谱法定量HM浓度。通过结构化问卷调查获得人口统计学和临床数据。贝叶斯核机回归分析显示,混合金属暴露对不良妊娠结局有显著的累积效应,具有明显的剂量-反应关系。PTB和LBW的风险随着暴露水平的增加而单调增加;调整后的优势比随着金属混合物浓度从第25个百分位增加到第75个百分位而升高。相反,与SGA的关联表现出非单调模式——低暴露水平风险较高,高暴露浓度风险显著下降。在单变量模型中,无机砷被确定为主要有毒成分。多变量响应模型显示了金属混合物对不良结局的共同影响(AUC = 0.697),平行剂量-响应曲线显示,单个金属之间没有显著的统计相互作用(p > 0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Heavy Metal Exposure During Pregnancy and Its Association With Adverse Birth Outcomes: A Cross-Sectional Study

Heavy Metal Exposure During Pregnancy and Its Association With Adverse Birth Outcomes: A Cross-Sectional Study

Prenatal exposure to heavy metals (HMs) has been the focus of international research. However, current studies tend to examine individual metals in isolation and rely on traditional linear regression models, which may not adequately reflect the complex, non-linear and interactive effects of mixed metal exposure. The aim of this study was to investigate the relationship between maternal mixed urinary HM exposure levels during pregnancy and adverse birth outcomes such as preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA) infants using advanced machine learning methods. This study was conducted at a tertiary hospital in Guilin, from 2022 to 2023. A total of 489 pregnant women were enrolled. First-trimester urine samples were collected to quantify HM concentrations using Inductively coupled plasma mass spectrometry. Demographic and clinical data were obtained through structured questionnaires. Bayesian Kernel Machine Regression analysis revealed a significant cumulative effect of mixed metal exposure on adverse pregnancy outcomes, with distinct dose-response relationships. The risk of PTB and LBW increased monotonically with higher exposure levels; the adjusted odds ratios were elevated as metal mixture concentrations increased from the 25th to the 75th percentile. In contrast, the association with SGA exhibited a non-monotonic pattern—higher risk at lower exposure levels and a marked decline in risk at higher concentrations. Inorganic arsenic was identified as the primary toxic component in univariate models. Multivariate response modeling demonstrated the joint influence of metal mixtures on adverse outcomes (AUC = 0.697), with no significant statistical interactions between individual metals, as indicated by parallel dose-response curves (p > 0.05).

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来源期刊
Geohealth
Geohealth Environmental Science-Pollution
CiteScore
6.80
自引率
6.20%
发文量
124
审稿时长
19 weeks
期刊介绍: GeoHealth will publish original research, reviews, policy discussions, and commentaries that cover the growing science on the interface among the Earth, atmospheric, oceans and environmental sciences, ecology, and the agricultural and health sciences. The journal will cover a wide variety of global and local issues including the impacts of climate change on human, agricultural, and ecosystem health, air and water pollution, environmental persistence of herbicides and pesticides, radiation and health, geomedicine, and the health effects of disasters. Many of these topics and others are of critical importance in the developing world and all require bringing together leading research across multiple disciplines.
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